Summaries of health policy coverage from major news organizations

The following summarizes recent studies related to breast cancer in Hispanic women race factors related to certain leg amputations, and premature birth and stroke among blacks.

Breast cancer: Like black women, Hispanic women are more prone than whites to be affected by an aggressive and difficult-to-treat type of breast cancer tumor, according to research presented last month at the annual Breast Cancer Symposium in San Antonio, Sacramento Bee reports (Griffith, Sacramento Bee reports, 2/6). Triple-negative or "basal-like" tumors -- which women with genetic mutations called BRCA1 tend to develop -- usually grow rapidly, spread quickly and are more likely to be fatal than other subtypes of breast cancer tumors. The tumors are not fueled by estrogen, so they cannot be treated with estrogen-blocking drugs, such as tamoxifen or raloxifene, and the breast cancer drug Herceptin also is ineffective (Kaiser Daily Women's Health Policy Report, 7/7/06). For the research, Sutter Cancer Center oncologist Vincent Caggiano and California Cancer Registry epidemiologist Monica Brown analyzed 1999-2003 data from the registry. Of 51,074 cases of invasive breast cancers, 12.5% were triple-negative. Of triple-negative tumors, 11% were found in whites, almost 25% in blacks and 17% in Hispanics. In general, "Hispanic women are at much lower risk for breast cancer but are at risk of triple-negative breast cancer. Why? That is what we don't know," Brown said (Sacramento Bee, 2/6).

Leg amputations: Low-income minorities have a higher risk than whites of undergoing a leg amputation as a result of severe peripheral artery disease than whites, according to a report published in the Journal of Vascular Surgery, Reuters Health reports. In people who have the condition, "plaque builds up in the arteries that supply the legs with blood, which causes them to narrow." The condition causes ischemia -- reduced blood flow and oxygen delivery to the legs -- and pain throughout the entire leg, Reuters reports. For the report, lead researcher Mohammad Hamed Eslami, a vascular surgeon at the University of Massachusetts School of Medicine, and colleagues analyzed hospital data on 691,833 adults diagnosed with leg ischemia and found that roughly two-thirds required vascular grafts to treat their condition and that nearly one-third had the affected leg amputated. Participants with low incomes, minorities, individuals without private group insurance, and Medicare and Medicaid beneficiaries had significantly higher rates of amputation than other groups, researchers found. Eslami said some people who have received good and timely care still will undergo amputation, possibly because of a delayed diagnosis or delayed referral to a vascular surgeon. Researchers said the findings indicate a "disparity of care provided" to low-income, minority patients and recommended eliminating barriers to care and improving education on symptoms of the disease (Rauscher, Reuters Health, 2/1).

Premature birth: Genetics is likely why black women are more than twice as likely as whites to give birth prematurely, according to a study published Friday in the American Journal of Obstetrics and Gynecology, the Kansas City Star reports. For the study, lead researcher Louis Muglia of Washington University and colleagues examined Missouri Department of Health and Senior Services birth records of 300,162 white women and 63,223 black women who had two or more births between 1989 and 1997. Researchers found that even when taking into account differences in societal and health factors, 9% of black women gave birth at between 20 and 34 weeks' gestation, compared with 3% of white women, which is comparable to national rates. Most women give birth at 40 week's gestation. Muglia said the finding suggests that each woman likely has a genetically set biological clock that determines when she is most likely to deliver, adding that, "My bet is it's not just one gene. ... Variations in African-Americans tend to set the clock earlier" (Bavley, Kansas City Star, 2/9).

Stroke awareness: Black women who were educated about the warning signs of stroke from their hair stylists during appointments learned to recognize the symptoms, but they did not alter their behavior, according to a study released on Wednesday at the American Stroke Association's conference in San Francisco, the Cincinnati Enquirer reports. For the study, lead researcher Dawn Kleindorfer of the University of Cincinnati and colleagues educated a number of black hair stylists in Cincinnati and Atlanta about the risk factors and warning signs of stroke. The stylists then relayed the information to their regular clients. Of 318 clients, 40.7% knew three warning signs for strokes before learning stroke information from their stylists, compared with 50.6% who knew three risk factors after discussing information with their stylists. Kleindorfer said, "The message about the warning signs stuck with women. What didn't stick was the recognition of risk factors, such as diabetes, smoking, weight. Behaviors didn't change an iota, unfortunately" (O'Farrell, Cincinnati Enquirer, 2/8).

Stroke outcome: Black stroke patients who receive care at hospitals that treat a large number of minority patients have worse outcomes than those treated at other hospitals, according to researchers at Massachusetts General Hospital, the HealthDay/Austin American-Statesman reports. For the study, lead researcher Lee Schwamm and colleagues examined data on stroke patients treated at 656 hospitals participating in the American Stroke Association's "Get With the Guidelines-Stroke" program. At hospitals treating the largest number of black patients, fewer blacks than whites received drugs to treat acute ischemic stroke; fewer blacks than whites were prescribed blood thinners when they were discharged from the hospital; and blacks were less likely than whites to be referred for smoking cessation efforts, according to the research. Researchers did not find the racial disparities at hospitals that treated more white stroke patients (HealthDay/Austin American-Statesman, 2/8).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.